PMID- 31120713
OWN - NLM
STAT- MEDLINE
DCOM- 20200514
LR  - 20200514
IS  - 1936-2692 (Electronic)
IS  - 1088-0224 (Linking)
VI  - 25
IP  - 5
DP  - 2019 May 1
TI  - Pilot of urgent care center evaluation for acute coronary syndrome.
PG  - e160-e164
AB  - OBJECTIVES: Patients with chest pain and concern for potential coronary ischemia 
      are frequently referred to the emergency department (ED), resulting in 
      substantial resource utilization and cost. The objective of this study was to 
      implement a protocol for urgent care center (UCC) evaluation of potential acute 
      coronary syndrome (ACS) and describe its performance. STUDY DESIGN: This is a 
      descriptive, retrospective review of consecutive cases included in a protocol for 
      UCC evaluation of ACS. METHODS: Consecutive patient encounters from 4 urgent care 
      facilities of our regional integrated health system were reviewed from a period 
      spanning 4.5 months of the 2017 calendar year. The primary outcome was avoidance 
      of an ED visit within 30 days of the index visit, and the primary safety outcome 
      was serious adverse events (AEs) occurring in the UCC setting. RESULTS: There 
      were 802 patients evaluated, with a median age of 55 years, and 58% were female. 
      Seventy-three (9.1%) patients were referred to the ED or hospitalized for any 
      reason at the index visit, 10 (1.2%) of whom were ultimately diagnosed with ACS. 
      Within 30 days, 56 (7.7%) of the remaining 729 patients had ED visits or 
      hospitalization for any reason, 2 (0.2%) of whom received a diagnosis of ACS. 
      Overall, 673 (83.9%) patients were managed without any ED visit. No serious AEs 
      were recorded. CONCLUSIONS: Our initial pilot data demonstrate the feasibility of 
      an outpatient UCC evaluation for ACS without refuting the underlying premise of 
      safety.
FAU - Radecki, Ryan P
AU  - Radecki RP
AD  - Kaiser Permanente Northwest, 500 N Multnomah Ave, Portland, OR 97232. Email: 
      ryan.p.radecki@kp.org.
FAU - Foley, Kevin F
AU  - Foley KF
FAU - Elzinga, Timothy S
AU  - Elzinga TS
FAU - Horak, Cynthia P
AU  - Horak CP
FAU - Gant, Thomas E
AU  - Gant TE
FAU - Papp, Heather M
AU  - Papp HM
FAU - Morris, Adam J
AU  - Morris AJ
FAU - Hauser, Natalie R
AU  - Hauser NR
FAU - Ertz-Berger, Briar L
AU  - Ertz-Berger BL
LA  - eng
PT  - Journal Article
DEP - 20190501
PL  - United States
TA  - Am J Manag Care
JT  - The American journal of managed care
JID - 9613960
MH  - Acute Coronary Syndrome/complications/economics/*therapy
MH  - Adult
MH  - Ambulatory Care/economics/*statistics & numerical data
MH  - Chest Pain/etiology
MH  - Emergency Service, Hospital/economics/*statistics & numerical data
MH  - Female
MH  - Health Services Accessibility/economics/*statistics & numerical data
MH  - Health Services Misuse/economics/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Referral and Consultation/economics
MH  - Retrospective Studies
MH  - Time Factors
EDAT- 2019/05/24 06:00
MHDA- 2020/05/15 06:00
CRDT- 2019/05/24 06:00
PHST- 2019/05/24 06:00 [entrez]
PHST- 2019/05/24 06:00 [pubmed]
PHST- 2020/05/15 06:00 [medline]
AID - 87999 [pii]
PST - epublish
SO  - Am J Manag Care. 2019 May 1;25(5):e160-e164.